Book reviews

The Meaning of Treason. By Rebecca West. New York: The Viking Press, 1947. Pp. 307. $3.50. Treason is the measure of many things today. The rules defining it are among the few great rules of law of any society. Treason, by the scope of its definition and application, measures the effective difference between police state and democracy. Treason, by the frequency of its appearance, is a measure of the health and well-being of a society. Treason, because it is perhaps the most fundamental of crimes, is also a measure of our understanding of the deviant impulses and pressures that appear to make law necessary. It is with the last of these thipgs that Miss West is especially concerned in her study of twenty or so men brought to trial in England as traitors at the end of World War II. The result is a superb book contributing to law, to psychology, to journalism, and, with the greatest distinction, to the contemporary writing of the English language. Treason's harvest is not quite what we should have expected. The Germans appear to have placed a high price on inducing British treachery at even the lowest levels.x They concentrated on the weak and the uninformed and alternately coerced, bribed, and seduced. A few who were very young, or eccentric, or had genuine German ties succumbed. In one case the man was a traitor technically only because the overshrewd Germans, suspecting him as a spy, delayed so long on his application for German citizenship. If this were all, the study of the trials would serve only to corroborate the remarkable morale of the English during the war, and would be a study only of the pathetic and the eccentric. But there are three other cases not so easily understood: William Joyce, the Lord Haw-Haw who, simply by broadcasting, may well have made himself the most hated traitor in English history; John Amery, son of a distinguished family, who moved unsteadily from a career as playboy to aide and gun runner for Franco and then to ally of the Germans in the effort to bribe British prisoners to enlist in the British Free Corps; and Dr. Allan Nunn May, a distinguished scientist who gave or sold some atomic bomb data to a Russian agent. It is, I think, the one flaw of the book that Miss West did not make a more coordinate study of these three. We get only a few pages on May which do not take us far enough for the intended comparison of Communist and Fascist to be effective. We get some thirty pages on Amery, beautifully and sensitively done, but these again are not enough to give us a clue as to how so happy an environment could produce so perverse a son. It may be that at this stage of our knowledge of these things no one could do more, and Miss West's final comment on Amery is perhaps the only

From the parts of the preceding quotation, which are printed in Italic letter:-,, it is evident that Dr. Cullen regarded his doctrine 01 fever as little more than an hypothesis, calculated to give arrangement to detached facts, which, without some system, readily slip from the memory.
? " He believed, indeed, and it must be admitted, thaj it was founded on a better principle than that,of any of his predecessors, except Hoffman ; and he perceived that it was more simple and consistent than the doctrines of this writer ; but he looked forward to a more advanced state of science, in which his system would suffer a change similar to that which he had effected en Hoffman's. All this he expresses' fully in the Preface to his First Lines " Upon this general plan," he observes, " I have endeavoured to form a system of physic that should comprehend the whole of the facts relating to the science, and that will, I hope, collect and arrange them in better order than has been done before, as well as point out, in particular, those which are still wanting to establish general principles. This which I have attempted may, like other systems, hereafter suffer a change ; but 1 am confident that we are at present in a better train of investigation than physicians were in before the time of Dr. Hoffman." " But setting aside what Dr. Cullen says of his doctrine, if we examine the doctrine itself, we shall find that if is wholly constructed on a hypothetical basis, on the supposed operations of the vis medicatrix nature, respecting which we have, in the Introduction to this Essay, given Dr. Cullen's opinion.
i( Hoy Dr. Wilson's Essatj on the Nature of Fever. t( How the debility of the nervous, proves an indirect stimulus to the sanguiferous, system ; how this stimulus acts in exciting the cold stage and spasm; how, through the intervention of these, the action of the heart and larger arteries is increased ; is only explained by reference to the operation of the vis medicatrix, that is, is not explained at all; and yet it appears, even at first view, that on these the whole system rests. " Shall we suppose f)r. Cullen, after declaring * that whcre-?ver the vis medicatrix is admitted into medical systems it throws an obscurity on them,' so inconsistent as to offer as a true system one wholly and avowedly founded on the supposed operations of this agent!" Dr. Brown's system is detailed more at large, and to do justice to the author of the work before us, that detail is more candid, as well as perspicuous, than any wo have met with among the numerous-adversaries of that unfounded system. It shews with much perspicuity, that Brown felt it impossible, if not dangerous to his opinions, to give any where a regular statement of his doctrine. That he proved, what no one would dispute, that when a man is tired he must rest; that certain substances proved a stimuli to an organization, which, without such stimuli, would cease to move, and that when such stimuli could no longer excite action, that excitability was extinguished, and the organization could no longer be maintained. The principal objection made by Dr. Wilson to Brown's Theory is, that no distinction is made between the series of action in those organs ivhich he calls vital, whose functions are constantly necessary for the maintainence of life, and others which he calls animal organs, whose actions are only occasional for the comfort of the animal, and for enabling him to supply those deficiences in the system, which the constant operation of the vital organs induce. Other objections are made to the theory, as confounding the state of excitement in health with that under disease: and also, that no distinction is made between the various kinds of stimuli, or agents, their effects, and the means of removing them. Thus direct debility being that state in which excitability is accumulated, must, under some circumstances, be a state of health, and the various shades of accumulation tending to disease can Tsever be ascertained. The passions are agents of a peculiar kind, the effects of which cannot be removed, but by tho application cf similar agents, whether they are called stimuli or not. 44 The hypothesis of direct debility supposes, that the abstraction 4 of any one oft these agents renders the system more sensible lo f:very agent, and that the effect of all is, at all times, excitexient. " The facts are, that the abstraction of any one of those agents #nly renders the body more sensible to the action of that agent; and the effect of that agent is not always excitement, but cither excitement or atony, according to the degree in which it is ap-? -~ plicd? plied, and the state of the body at the time of its application, tha* is, according to the change it induces. " If the change is moderate, it proves a stimulus ; and, within a certain range, the greater the change the greater is the excitement.
Beyond this, as wc have seen in the instances of opium and distilled spirits, it occasions debility; and, when excessive, death.
" When the change induced is consistent with the health of the parts on which the agent acts, excitement is the consequence ; but when the change is sufficient to derange the mechanism of the living solid, if I may use the expression, its immediate effects are debility or death. Nor is this more remarkable of the agents which are directly applied to the living solid, than of those whose first impression is on the mind. The passions, within a certain degree of intensity, act as stimuli; beyond this they debilitate, and even extinguish life, without previous excitement.

"
The degree of exhaustion which follows the operation of any agent is always proportioned to the excitement it occasions; but the degree of atony which a greater quantity of the same agent produce', bears no proportion to its exciting power. Thus tobacco will not occasion the same degree of excitement which opium or distilled spirits do, but it is better fitted to produce atony. ** Of those agents whose first impression is on the mind, some, grief, fear, disgust, are ill calculated to excite, although, when present only in a small degree, they act as stimuli; but they are chiefly calculated to produce atony ; others, love and joy, on the contrary, produce much excitement, and only occasion atony when in excess. " With respect to what Dr. Brown says of the depressing passions, as it makes a part of his hypothesis of direct debility, it must fall with that hypothesis ; unless we allow that grief, fear, &c. occasion an accumulation of excitability, there is nothing which Dr. Brown says on this subject that can be admitted. According to a law of the animal economy, I have just had oceason to mention, those under the operation of grief are rendered more sensible to joy, and those under the operation of fear to confidence; but they are rendered less sensible to the operation of every other agent. His assertion that grief is only a less degree of joy, and fear nothing more than a diminution of confidence, is quite gratuitous. He might with equal reaon assert, 1 that confidence is a dimiuntion of fear, and joy a less degree of grief. The one set of passions are as positive agents as the other: and if the one tend more to excite, and the other to depress, it is only what is true of agents of every other species." Dr. Brown, it is added, terms those diseases sthenic, in which a greater degree of excitement exists than in health. But such an excitement, if really diseased, is followed by atony. For, if mere exhaustion follows, which may be relieved by sleep, such a' state 46ft Dr. Wilso nys Essay on the Nature of Fever. state cannot be called diseased. Or, in other words, if excitement produces exhaustion only in the animal powers, which may be readily restored ; we are not to confound such a state with a morbid excitement, which debilitates the vital, as well as tho animal functions. " Upon the whole," adds our author, u the following, as far as I am capable of judging, are. the facts which Dr. Brown overlooked in forming the great outlines of his hypothesis. " There is no accumulation of excitability beyond that which constitutes a state of the most perfect vigour. There is no exhaustion of excitability, in the sense in which Dr. Brown uses the term, beyond that which constitutes the most perfect sleep, and both are equally states of health. " Every agent is capable of producing either excitement or atony, according to the degree in which it is applied. " In health, the natural agents applied in the usual degree, viz. a certain temperature, a certain quantity of exercise, &c.
always occasion that kind of excitement which is followed by exhaustion.
" In general disease, that is, in fever, which is the only general disease properly so called, the state of the excitability is so changed, that the same agents do not produce a greater or less degree of the same effects they produce in health, as Dr. Brown, supposes ; but either atony, or that kind of excitement which is followed by atony. " It must appear, I think, to every one who attentively considers the hypothesis of Dr. Brown, that its author, in speaking of diseases, has constantly in view the healthy state of the animal body; and attempts, in vain, to apply the laws which regulate the excitability of certain parts of the system in health, to explain the phenomena of disease." This leads our author to bis own theory of the proximate cause of fever.
He begins, by dividing the functions of the human body, as we observed when reviewing Dr. Clutterbuck's work, into the vital and animal.
When we read this passage, it affords ideas so precisely similar to Dr. Cullen, that, we confess ourselves unable to see any difference, excepting that the Professor acknowledges himself dissatisfied with his theory ; whilst Dr. Wilson promises us " to establish his position by reviewing the three heads of the Symptoms, Causes, and Cure of Fever." Under the first article, we find the enumeration of almost every symptom ; and, like most other systematic writers, the author feels 110 difficulty in accounting for all, according to his favourite hypothesis. He goes indeed a little owt of his way, to show that Cullen ?was mistaken in imputing any of these symptoms to a putrcscency of the fluids, induced by marsh or human effluvia becoming putrefactive ferments. These opinions, not only have not survived tbe author, but died before him. But we feel no greater satisfaction from Dr. Wilson's remarks on the putrefaction of the contents of the stomach and alimentary canal by stagnation, or of the stagnation and putrefaction of the natural moisture on the surface, by the failure of the secretion and absorption at those parts. This putrefaction, as it is called, and this cadaverous smell, we impute to an alteration in the secretions themselves, and not to any particular change after the process of secretion.
The remote causes of fever arc next enumerated ; and we are assured by the author, that whatever they may be, whether Gold, fatigue, or contagion, the operation of each, is to induce debility. These are subjects we shall not dispute with Dr. Wilson.
Under the last article of Treatment, little novelty could be expected. Some judicious hints occur, besides the common routine practice; and if we are not satisfied with the author's mode of reasoning upon any, we strongly suspect that our readers will excuse us, when we decline entering into an argumentative detail on the subject.
Such is the nature of the work before us.
It is particularly tnfortunate for the author, that Dr. Clutterbuck should have so immediately preceded him. Though we are not perfectly satisfied with either, yet, it is impossible not to compare the solid reasoning of the one with the unfounded theories of the other. His Prussian Majesty became so much alarmed lest the Yellow Fever should find its way into his dominions, that he offered a prize prize medal to the author of the best treatise on the subject. The words of the Conspectus, relative to this question are so remarkable, that we cannot help copying them for the instruction of our readers, that is, that they may avoid falling into similar difficult ties.
Had this learned body maturely considered the nature of their position and consequent question, they must have recollected that \ve know of no contagions requiting contact with the sick, to produce their effect, excepting such as induce their diseased action on the part touchcd. 'It would, therefore, have been desirable to illustrate their meaning, by exemplifying the venereal, or some other poison producing its effect in this way. When it is said of the plague, as it has been by some people, that it is only contagious by contact, and when it is considered at the same time, that we can find no visible change in the part thus touched ; that contact is often not followed by any consequent disease, and that those who are not exposed to contact, are sometimes affected ; the only inference we can draw, is, that if the disease be contagious, the laws of that contagion is not yet understood, and therefore, that every person gives his surmise according to the individual facts which havp passed before him. Having said thus much on the question, let us now attend to the manner in which it is answered. In the paper before us, Dr. Blane begins by observing,, that his various duties and occupations will not admit his drawing up an answer agreeably to the form prescribed, but as the disease in question has come largely under his notice, and as he^has been led to pay particular ( jSo, 105. ) I i attention.
attention to it at liomc and abroad, he hopes to relieve Ins Prussian Majesty from his anxieties relative to the public health from this epidemic.
It is next observed, that the disease has never appeared, excepting in tropical climatcs, 01 in those seasons when the temperature has been for some time equal to the tropical heat. This fact, Doctor Blane seems particularly desirous of " communicating to the Prussian Government, in order to remove any groundless fears with regard to the dangers to be apprehended to the states of his Majesty from this infectious disorder. In this respect, it is said to " differ from Small-pox and other specific contagions, but is very analogous to the plague, fur it is perfectly asce:? tained, that the prevalence of this latter epidemic is confined to a particular range of atmospheric heat, both in regard to climate and season." Another property of Yellow Fever we are told, is, " that it is never known to prevail but where the effluvia of the living human body existed in a certain degree of concentration." Dr. 13. has remarked, that the British armaments sent to the West Indies, have suffered most when numbers were confined to a spot, and " in his -work on the diseases of seamen, that this epidemic was most apt to * appear in the crews of crowded ships, bringing febrile infection from England or America." It is next stated, as a very striking property, that the disease has never been known to spread into the country among villages or single houses. Here again we are shown the resemblance of the Yellow Fever and plague, the infection of the latter having a great predilection to the crowded and ill aired parts of the town, on its first breaking out; but in its after progress, it spares no quarter of the town, nor even the smallest villages in the career of its devastation." Our author next attends to the opinions of those people, who, from the circumstances above related, have been led to suppose that the Yellow Fever is not infectious, and to others who have entertained the same " paradoxical opinion of the plague itself." " The infection of both, it is urged, may be aptly compared to the seeds of vegetables, or the eggs of animals, which require a nice concurrence of certain degrees of heat, moisture, rest, nutriment, See. to animate them. Infectious matter has, by a very appropriate metaphor, been termed the seeds of the disease ; and, by a similar propriety of expression, it has been said, that a certain nidus is necessary to give it effect. The nidus in plague is a certain range of atmospheric heat, which is a requisite sine qua noil; and a certain concentration and corruption of animal effluvia, which is not so indispensable, but which greatly facilitates the catching and propagation of it. The nidus of the Yellow Fever is also a given range of atmospheric heat, and a certain concentration and corruption of animal effluvia, both equally indispensable. It would >e too tedious to enumerate the various proofs, derived from my own 47! own observation, and the testimony of others, in proof of the infectious nature of Yellow Fever, I shall content myself with citing one, taken from my letter to Mr. King, Minister of the States of America to this Court, who applied to me, on this subject* in the year 1798. On the l6th of May, 1795, the Thetis and Hussar frigates captured two French armed ships from Guadaloupe, on the coast of America. One of these had on board some men ill of the Yellow Fever; and, out of fourteen hands, sent from the Hussar to navigate and take care of her, nine died of this fever before she reached Halifax, on the 28th of the same month, and the five survivors were sent to the hospital, sick of the same distemper. Part of the prisoners were sent on board of the Hussar; and, though care was taken to select those seemingly in perfect health, the disease spread rapidly in that ship, so that near on? third of the whole crew was more or less affected by it. not against the introduction of merchandise, but persons and their foul linen or other clothes, because though there has been an uninterrupted intercourse between the American towns and the West Indies, as long as the fever has been known in the latter, yet no proofs have occurred of the introduction of the disease, but by the sick or jlheir clothes. Another preventive means of the utmost importance consists in paying the strictest attention to ventilation and the cleanliness of towns, particularly by the introduction of common sewers." Such are the opinions of, and thus are they expressed by the author of " Observations on the Diseases of Seamen," the physician to the British fleet, &c. and we cannot help remarking how fortunate it is that men may practice well and reason very badly. It is impossible to doubt the integrity, industry, or practical judgment of Dr. Blanc ; and if we venture to say his reasoning is unsatisfactory, if not unintelligible, he~nvny at least be satisfied with being placed on tbecame footing with the illustrious Sydenham ! The first thing that must strike every reader, is, that the saine disease is indifferently called epidemic, contagious, and infectious, and that we are no where informed what is the precise meaning affixed by the author to any of these expressions. We find, indeed, a sort of distinction between specific contagions and the yellow fever. Among the former, the small-pox only is specified. Now let us ask what is meant by specific. If it is only that such contagion produces its own species, we must remark that Dr. Blanc attempts to confine the Yellow Fever to certain laws, by which this species of injection may be detected in various parts of the world through "which he traces it. " The most distinguishing symptoms says he, of the Yellow Fever, are, a yellowness of the skin, the vomiting of a dark coloured fluid, its generally proving fatal from the third to the seventh day, iind marks of inflammation on the stomach upon inspection after death/' " It is, says our author, manifest that different species of infection are regulated by different laws. The small-pox propagates itself at all seasons, climates, and situations." The plague and Yellow Fever only under certain circumstances. By this, all the infections seem referable to some one species ; but if we are to make a distinction between general and specific, according to certain laws, the small-pox which propagates itself in all seasons, climares, and situations, seems of all others the least entitled to be restrained by the terms specific. We wish our readers to understand that they are not to consider these remarks as etymological, or that we have any intention to object to any terms or qualifications of them by which Dr. Blane may chase to illustrate his meaning. Out objection is, that we cannot by the closest attention to his paper, derive those benefits from it which we might have done, had he explained .all his terms, or avoided applying the same terms to qualifies which he wishes to separate.
Let us now attend to the laws which Dr. Blane conceives established* The Edinburgh Journal. 47j blished. The first is, that Yellow1 Fever is unknown, excepting in tropical heat. This we believe is pretty universally admitted.? Besides this, using a metaphor from vegetation, he tells us that " the nidus of the Yellow Fever is a given range of atmospheric heat, a certain concentration and corruption of animal effluvia, both equally indispensible." Before this, we are told that this fever has never been known to prevail but where the effluvia of the living human body existed in a certain degree of concentration.
These last words admitof no question as to their import. The former terms are therefore too general, and the word corruption is improper, as it might lefid the reader to imply the putrefaction of dead animal matter of any kind. But as we have just remarked, the author's terms are precise as to the cause ot Yellow Fever, namely a high temperature and the concentration of living human effluvia.
"The British armaments, he adds, sent to the West Indies, have always suffered most when most crowded ; the cpidcmic is most apt to appear in the crews of crowded ships, bringing febrile infection from England or America/' " is more common in ships of the line, especially, if not clean or well aired, than in frigates or other smaller vessels." After this, it is thought sufficient to cite one proof among the many.which it would be too tedi-tion. and long continued calms aided the accumulation of the evolved gasses. That the ship or camp fever in tropical climates should assume many of the symptoms of a fever peculiar to those regions is not to be wondered at, when we consider the violence of the common remittent, which is often imputed to no other causes than such as in colder countries produce common ague. But whether thus much is admitted or not, we shall not undertake to de-cide; yet we cannot help expressing our wish, that in so important a question, Dr. Blane had given us some better reasons for suscepting the contagious nature of the Yellow Fever of America, than his history of a fever, communicated by a French prize. What  Jndies, should never have received the sick or their foul linen, or other clothes during their hot season ! But if it has invariably happened, that the fever has only occurred during a high temperature and long calms ; shall we boldly undertake to ascertain, contrary to the observations of some of the best informed practitioners of America, that the presence of a subject, or of a fomes, is necessary to excite such a disease ?
We have dwelt so long on this paper, on account of fhe celebrity of its author, as well as the importance of the subject. We sincerely wish he would peruse what has been written by others, ?who, though less acquainted with " the diseases of seamen" have much larger opportunities of tracing the Yellow Fever. Dr. Rush's opinions, though once violently opposed, are gradually gaining ground among his countrymen, and their improvements in cleanliness, seem likely to supersede the imposition of vexatious and unnecessary quarantines. Article 2.?Further Observations on the Egyptian Ophthalmia, as it affected the 2d Battalion of the 52d Regiment. In a Letter to George Peach, Escj. Surgeon to the 2d Battalion, 52d Regiment, to James M'Giiegou, M. L). Fellow of the Royal College of Physicians, Edinburgh, and Deputy Inspector General of Hospitals, Portsmouth.
In the first part of this paper, the author shows the great advantages which attended copious veiuesection in the manner recommended by Mr. Knight. One man was bled to the amount of 774ounces.
By an attention to this bold practice in.st|jjfe. early stage, the disease was entirely subdued. In some varieties of the complaint, advantage was found in destroying the small arteries by lunar caustic; some useful practical remarks follow, on the means 11 preventing the extension of the disease.

Article
Article 3.?A Case of Scirrhus Ulceration of the Pharynx and (Esophagus. By George Kitson, Member of the Royal College of Surgeons, London.
Tii is is one of those melancholy cases in which physic has hitherto made scarcely any progress, excepting to teach us how little can be done. What is most surprising is, that though the patient from inability to swallow, had for a considerable time been confined to little more than a tea-cup full of food in the course of the day, yet she retained strength sufficient to accomplish her customary duties as a servant, and less than three weeks before her death, walked eight miles to see hei* friends, returning on the following day. We know not whether most to admire the diligence of Mr. Dawson in collecting every information, or his candour in acknowledge ing the sources of improvement. We have often regretted that the practitioners of London read so little. The few secondary haemorrhages which occurred, the author supposes were venous, as they ?were easily subdued by compression, The operation, proved successful. ? Article 6.?Biographical Skctch of Spalanzani. The account of this industrious experimenter is short, but interesting, inasmuch as it reters to a man whose numerous experiments could not but increase the field of natural knowledge. Vet Spalanzani himself had certainly not that talent of induction, which by teaching-him how to institute and conduct his experiments, would have enabled him to draw just and practical inferences. He was moreover, too fond of wonders for an experimental philosopher. Article 7History of Hydrophobia, with the Appearances on Dissection. By M-P. C. Goitcy, Member of the Legion of Honour, formerly Chief Physician to the Army, and Physician of the Hospital, at Metz. This case, extracted from the Journal de Medicine, eye. of Corvissart, Leroux, and Boyer, is in many respects interesting. It terminated like most others. Some circumstances induce the relator to believe that the disease did not arise from the bite of a rabid animal, but was spontaneous Hydrophobia.
The arguments are thus summed up by the compilers. 4f 1. The dog was young, quarrelled with its fellow, which.it 1 i 4 bit 4?6 Dr. Bree, on Disordered Respiration. bit sevo-rely ; and it was in attempting to separate them, that first the huntsman ^d then the master were bitten. " 2 It was not at the time supposed to be mad, and, during his whole illness, its master never imagined that the bite was the cause. " 3. Neither the other dog, huntsman, nor another child, whom the same dog had bitten, suffered any bad consequences from the bite. " 4. The supposition that the bite of an animal merely enraged can produce hydrophobia is without proof. " 5. Communicated hydrophobia proves commonly fatal on the? fourth day ; the fatal case of spontaneous hydrophobia, mentioned by iSalius Diversus, terminated on the eighth, the duration ol' the illness in this case.* " 6. If it be correct that the breaking out of the cicatrix, or at least, that swelling and pain in the place bitten, are constant precursors in hydrophobia, these were wanting in this instance." Articles 8, 9> and 10, will be given in our next Publication. We noticed this work with approbation in a former Number. The fourth edition proves, that the inquiry into causes of asthma has interested the public in no common degree. It is enlarged with the result of additional experience and observation, which, at the same time, add authority to the principles of the work. The author is of opinion, that asthma proceeds from various disease^; and that the spasmodic action of the muscles of the thosrax may and do take place, for the purpose of removing irritations or injuries from the abdominal, as well as from the thoracic viscera.
Amongst the causes, he particularly notices acrimony in the stomach and bowels, from indigested aliment, or vitiated secretions. Causes of asthma are also said to exist in irritations or diseases of the urinary organs, and of the uterus. Many cases are given in support of these causes of asthma, all of which, with the practical observations, are deserving of serious attention. We will give some extracts from the new matter, which this edition furnishes. Respecting tonics, Dr. Bree remarks, that " ihe debility of the vascular system is particularly productive of " * A case of hydrophobia occurred in Edinburgh last summer, in which the patient lived fifteen davs alter the first appearance ot t it, usease, * eight months after being bitten. There was no doubt of the disease a communicated, for" the dog was destroyed as being mad, and,the hrst sy ptom was an inflammation, and papulary-eruption on the part bitten.^ other respects, it had a considerable resemblance to Mr. Uorcy s ca.e. Dr. Bree, on Disordered Respiration* /fif of a languid circulation in the lungs and liver. A feeble and slow circulation in these organs has been sufficiently pointed out as the cause of serious effusion, or of such a turgid state as may occasion difficulties of breathing, forming a paroxysm of asthma, or a disease of a chronic character. This existing state seems to have caused that apprehension of tonics, which has generally prevailed amongst phy icians in the treatment of asthma. But the state now described is that of passive weakness, and not active tone or inflammatory disposition. It requires, therefore, an appropriate treatment, which has not been usually applied." from the stomach; and in many more, when they had not passed the bowelt. Great inflation and acidity soon added to the irritations. " If the influence of such causes be well understood, a dose of opium would not be prescribed before the acrimony had been discharged, though, after its removal, this antispasmodic might be useful.
\ i " It may be supposed that a case of this kind would be readily distinguished, but the fact is otherwise. Tiie violence of the asthmatic affection seems to arrest the whole attention of observers, when a simple evacuation of the stomach is sometimes the only effect required to remove it. " This was the case of Mr. I. S. who had suffered asthma for a long time, and been treated in the usual way. With great vivacity and intelligence, he is fond of society, and in his enjoyment of company he forgets bis rules. " Preparations of iron were eminently serviceable to him, but not so strikingly useful as rhubarb and magnesia, which were afterwards taken every night by the advice of a judicious apothecary. The fit was prevented by this method ; and it is even probable that no other means would be necessary to confirm a cure, if he would be more guarded in his diet." " Lieutenant S. of the royal navy, had been long affected with disordered secretions of bile, and all the symptoms of indigestion and general debility. When he consulted me, the asthmatic attacks came with great violence, and were evidently excited by the occasional state of the first passages in his feeble habit. The use of gentle aperients with stomachics, was followed by that of vitriolic acid and tincture of cascariila; and afterwards by vitriolated iron, rhubarb, and pulv. aromat. Iiis general habit was strengthened; his sweats left him, his digestion gradually improved, and the fits did not appear during a long period of progressive improvement of general health. In this state he took a violent cold, but he was but little affected in his breathing. His bowels, however, became more lax than usual; and this disorder, after a few days, increased to a purging. I yielded to his wish, and prescribed chalk mixture and opium with rhubarb. The day after he began this medicine, he congratulated himself that the bowel complaint had ceased; but on the second evening, he had a very violent return of asthma. I then prescribed for him a mixture of magnesia and infusion of senna. His lax state of the bowels soon returned, and the fit was suspended after two motions; the diarrhoea only continued a few days, and left him well. " But when affections' of the liver occasion asthma, there is a great difficulty in the management of the stomach. II cordials and a meat diet be limited considerably, for the purpose of avoiding a turgid state of the liver, the spasmodic breathing is likely to be increased. Such is the habit of an asthmatic subject, that it cannot be concluded without experience in his case, that evacuants will be beneficial* although the irritating cause be so manifest. Every habit seems to have its peculiar character, subordinat ? to the ?general principle of the disease; and it is owing to these idiosyncrasies, that opposing qualities of medicine are found to be useful in different cases of the same complaint. Which of the acids, therefore, may be most efficacious, cannot be safely asserted without some trial. The acetous acid has been spoken of, as best applied, when the coats of the first passages are irritated by bilious acrimony, tvhich it may seVve to neutralize. This condition is very probably common to asthmatics, although it be not immediately detected amongst the possible causes of the disease. " The mineral acids are not so likely to answer in relieving the fit as the-vcgctable acid; but a draught, with nitric acid much diluted, has been given with advantage in both states. The vitriolic acid lias been proved to be a powerful tonic, taken three times a day in the intermissions. Tincture of cascarilla addsto its efficacy. The habits in which it was most efficacious, were affected with frequent bilious disturbances of the alimentary canal, and much dyspepsia and eruptions of the skin, with general relaxation and weakness. In these circumstances 'the improvement of health was progressive, and the fit was lost. But the acetous acid cannot be depended upon for relief in the fit ; and when dyspepsia, entirely unconnected with bilious acrimony, is predominant, testaceous powder is to be preferred, sometimes combined with magnesia, and small doses of Ipecacohan. " Asthmatic attacks take place very commonly, when the viscera of the abdomen are turgid; at the same time that the stomach is torpid, and affected with flatulence and acid juices, and the urine is deficient and high-coloured. It is then that natron shews admirable effects, but not very rapidly; it should be given daily with bitters and rhubarb. It may be united occasionally with an aperient of more force; but four grains of rhubarb every night, and six grains of natron twice or three times in the day, produce a change in the secretions of the alimentary canal, which may, in many instances, remove the asthma without other means. The means, however, of confirming the change of habit, ought never to be neglected?by bitter infusions, and preparations of iron, With a strict diet." Strong purging is frequently hazardous. " "Whoever attempts it, must bear the ill humour of his pat'ent, and excite'many paroxysms for the uncertain attainment of ultimate success.
Where purging is apparently necessary from the cause of the complaint, I have found it prudent to neutralize acidities, and dissolve viscid secretions; and in the course of this treatment, to,discharge the irritating matters in a gentle manner." " Those habits in which a more vigorous practice can be adopted, offer exceptions to general rules." Dr. Bree concludes with that respectful attention to the opinion of his brethren, which evinces his liberality; and is, at all times, honourable to science; * j?